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About 8 million Americans suffer from gout, according to the American College of Rheumatology. While men are particularly vulnerable to gout symptoms (6 million American men have the condition), women become increasingly susceptible to gout as they get older.
Menopause may be what causes gout in older women. Studies suggest that the hormone estrogen may protect women up to a point, but they become vulnerable as estrogen levels drop during and after menopause.
It’s important to take gout symptoms seriously. Research has linked the condition to a higher risk for several serious chronic health issues, and a 2015 study associated gout symptoms with poor lower extremity function in the elderly.
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What Causes Gout?
Gout is a painful form of inflammatory arthritis that occurs when uric acid accumulates in the body and causes crystal-like deposits to form in the joints. This build-up leads to the sudden onset of intense pain, swelling, and tenderness in a joint. In younger people, gout commonly starts in one joint (usually the big toe), but in older adults, gout symptoms may present in the knee, or in multiple small joints of the hand.
The pain may develop during the night and has been described as throbbing, crushing, and/or excruciating. The affected joint will appear red, and may be warm and tender to the touch.
Acute gout symptoms eventually subside on their own, but the condition can be very painful. You may suffer from one attack of gout and never experience it again, but more than half of the people who experience gout will suffer from more than one attack, and subsequent attacks often take longer to subside. It also is possible to develop what is called chronic tophaceous gout, which can cause joint damage and loss of motion.
Who Gets Gout?
What causes gout can essentially be narrowed down to high uric acid levels (known as hyperuricemia). The body produces uric acid when it metabolizes purines: substances that are naturally present in the body, and also contained in certain foods.
Normally, uric acid is excreted via the kidneys, but if it builds up, and/or the kidneys fail to excrete it properly, hyperuricemia can result. However, hyperuricemia doesn’t always cause gout; in fact, only about one-third of people with high uric acid levels develop the condition.
People with high uric acid who do develop gout symptoms tend to consume more alcohol, meat and seafood, use certain diuretics (medications that are prescribed to treat high blood pressure), and are obese. Hyperuricemia without gout symptoms doesn’t require treatment, but if symptoms do develop, you will need treatment.
Gout is associated with a higher risk for high blood pressure, kidney disease, diabetes, and obesity partly because of the effect these conditions have on kidney function. They increase your susceptibility to hyperuricemia because they affect the way the kidneys process uric acid. Additionally, many people with these comorbid conditions may be taking thiazide diuretics and/or daily low-dose aspirin, both of which can inhibit the excretion of uric acid.
Treating and Preventing Acute Gout Symptoms
Acute gout is treatable and there also are ways to reduce the risk that it will recur. Treatment of flare-ups generally includes high-dose nonsteroidal anti-inflammatory drugs (NSAIDs).
If you’re an older adult, be aware that you are at increased risk of cardiac, renal, and gastrointestinal adverse events from these drugs, so speak with your doctor before taking them—he or she may recommend other or additional medications to decrease your risks.
Can a Special Diet Help Recurrent Gout?
Alcohol reduction, low-dose colchicine, and medications to decrease uric acid are common strategies used in treating gout symptoms. You also may be able to prevent recurrent gout by following a gout diet.
There are certain foods to avoid with gout, and while it isn’t clear whether a gout diet is better than taking drugs, experts believe it may ease symptoms. For more on gout and your diet, see these University Health News posts: